摘要
产后恶露不绝(PL)是以产后血性恶露持续10 d以上淋漓不尽为主要临床表现的产后复旧异常性疾病,中西医发病机制复杂,药物作用机制尚未明确。笔者通过查阅近年来国内外相关研究,从中西医两个角度总结产后恶露不绝的发病机制和药物作用机制,发现该病以冲任气血失调,多虚多瘀为本为基本病机,常用药物分单味中药和中药复方及其制剂,通过多靶点、多通路调控相关因子的转录表达,发挥促进子宫收缩、调节胶原代谢、调节激素及其受体表达、促进血管再生、调控细胞凋亡、增殖和分化、下调炎症反应、维持出凝血平衡及影响机体能量代谢等作用促进产后恢复;西医常与子宫复旧不全、组织物残留及宫腔感染等机制有关,治疗以宫缩剂联合抗生素为主,作用方式及机制单一,中医治疗优势明确。该文拟对产后恶露不绝的中西医病因病机及药物治疗进行综述,构建其病机与作用机制间的联系,为该病的临床诊治及药物研发提供参考。
Postpartum lochia(PL) is an abnormal postpartum retrogression disease characterized by persistent bloody lochia lasting for more than 10 days.The pathogenesis of traditional Chinese and western medicine is complex,and the mechanism of drug action is not yet clear.The author summarized the pathogenesis and drug action mechanism of postpartum lochia from the perspectives of traditional Chinese and Western medicine by reviewing relevant domestic and foreign research in recent years.It was found that the basic pathogenesis of this disease is the imbalance of Chong Ren Qi and blood,multiple deficiency and multiple stasis.Commonly used drugs are divided into single traditional Chinese medicine and traditional Chinese medicine compound formulas and their preparations.By regulating the transcription and expression of related factors through multiple targets and pathways,it promotes uterine contraction,regulates collagen metabolism Regulating the expression of hormones and their receptors,promoting vascular regeneration,regulating cell apoptosis,proliferation and differentiation,downregulating inflammatory response,maintaining blood coagulation balance,and affecting energy metabolism in the body can promote postpartum recovery.Western medicine is often associated with mechanisms such as incomplete uterine involution,residual tissue,and intrauterine infections.The treatment mainly involves the combination of uterine contractions and antibiotics,with a single mode of action and mechanism.Therefore,traditional Chinese medicine has obvious and concrete advantages in treatment.This article aims to review the etiology and pathogenesis of postpartum lochia in traditional Chinese and western medicine,as well as drug treatment.It aims to construct the relationship between its pathogenesis and mechanism of action,providing reference for the clinical diagnosis and treatment of this disease and drug research and development.
作者
刘星童
刘雁峰
闫菲
庞颖
LIU Xingtong;LIU Yanfeng;YAN Fei;PANG Ying(Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100700,China;Headquarters of Beijing Nuclear Industry Hospital,Beijing 100045,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第19期257-266,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金面上项目(82274567)
北京市自然科学基金项目(7222280)
北京中医药大学东直门医院横向课题(HXDZM-202319)。
关键词
产后恶露不绝
发病机制
药物治疗
中西医
综述
postpartum lochia
pathogenesis
drug therapy
traditional Chinese and western medicine
review
